Cervical meningocele in association with spinal abnormalities

Abstract

A review of the literature relevant to this case is also presented.

Cervical (Non-terminal) Myelocystocele Associated With Rapidly Progressive Hydrocephalus and Chiari Type II Malformation -Case Report-

“…Additionally, our case was corresponded to``meningocele'' in the classifications of Andronikou et al 1) and Steinbok and Cochrane, 19) and to cystic spinal dysraphism with stalk in the classification of Salom ãao et al 17) Some clinical features of cervical cystic spinal dysraphism differ from those of lumbar or lumbosacral cystic spinal dysraphism. Cervical lesions are always covered with full thickness skin, so CSF leakage is rare, 6,12,13) with the neural tube almost closed with a midline gap, 12) and are associated with fewer neurological symptoms. 10,12,13,19,22) Cervical lesions are often associated with Chiari type II malformation and other spinal anomalies.…”

“…10,12,13,19,22) Cervical lesions are often associated with Chiari type II malformation and other spinal anomalies. 1,4,6,[9][10][11][12][13]17) Neurological symptoms are either absent or mild in cases of cervical spinal dysraphism. Only 1 of 9 cases of non-terminal myelocystocele was associated with paraplegia and incontinence.…”

“…9) The reported anomalies associated with cervical meningocele that are as follows: hydrocephalus, Chiari type II malformation, hydromyelia, lipomyelomeningocele, tethered cord, thickened filum terminale, diastematomyelia, Klippel-Feil syndrome, and thoracic hemivertebrae. 1,4,6,[9][10][11][12][13]17) Control of hydrocephalus associated with cervical meningocele greatly affects the cognitive prognosis. 9) Chiari type II malformation is not uncommon and is observed in 44-62% of reported cases.…”

“…14) This lesion is typically observed in the cervical, cervicothoracic, and thoracic regions and is often associated with some anomaly such as Chiari type II malformation and hydrocephalus. 1,4,6,[9][10][11]13,17) Plastic repair of the sac with adequate untethering has been recommended for cervical (non-terminal) myelocystocele. 9,10,13) However, respiratory distress after sac closure has been reported in a few cases, requiring immediate placement of ventriculoperitoneal (VP) shunt to prevent rapid deterioration of associated hydrocephalus and Chiari type II malformation.…”

Pathophysiology, Diagnosis, and Treatment of Spinal Meningoceles and Arachnoid Cysts

“…Closed dysraphism can be further divided into 2 subsets based on the presences or absence of a subcutaneous mass. Liposchisis, lipomyelomeningocele, meningocele, or myelocystocele may present as closed dysraphism with a mass, whereas, closed spinal dysraphism without a mass comprise complex dysraphic states ranging from complete dorsal enteric fistula to neurenteric cysts, split cord malformation, dermal sinus, caudal regression, spinal segmental dysgenesis, bony spina bifida, tight filum terminale, filum or intradural lipomas, and persistent terminal ventricle 1 .…”